基于数据挖掘探究中医药治疗急性心力衰竭的用药规律  

Exploration on the medication rules of traditional Chinese medicine in the treatment of acute heart failure based on data mining

作　　者：刘然 邹子萌 孙妍 李卫芬 沈悦 朱桂松[2] 许飚 LIU Ran

机构地区：[1]南京中医药大学,江苏南京210023 [2]南京中医药大学附属南京中医院,江苏南京210022

出　　处：《中医临床研究》2025年第2期22-28,共7页Clinical Journal Of Chinese Medicine

基　　金：南京市中医药青年人才培养项目(ZYQ20036);南京市医学科技发展重点项目(ZKX19032):细胞焦亡诱导脓毒症炎症风暴及基于“热毒”“血瘀”理论探讨黄葵煎剂干预效应的机制研究。

摘　　要：目的:运用数据挖掘技术对口服中药复方在急性心力衰竭中的应用特征和配伍规律进行研究。方法:通过知网、维普、万方、中国生物医学文献数据库(CBM)、PubMed五个中外文数据库,收集从建库到2023年12月中药复方治疗急性心力衰竭的临床随机对照试验研究文献。采用Excel 2021和R语言(4.2.1版本)对方药进行频率分析、关联规则分析及聚类分析,得到方剂的最核心药物及新型组方。结果:本研究共纳入处方189个,包括中药207味,总计使用1932次。气虚血瘀证、阳虚水泛证、心肾阳虚证为急性心力衰竭最常见的证型。黄芪、茯苓、丹参等中药在临床上的使用频率最高,药物的主要五味是苦味,并兼有辛味和甘味,归经出现频率最高的是手太阴肺经、足太阴脾经、手少阴心经。关联分析得出,白术–茯苓、丹参–黄芪、茯苓–甘草等为常用药物对,聚类分析获得4个新的方剂组合。结论:心力衰竭的基础病机是本虚标实,“本虚”以阳虚和气虚为主,标实是以“瘀”“水”为主。治法以益气温阳为主,辅以活血化瘀、行气利水,五苓散、真武汤、血府逐瘀汤等为治疗急性心力衰竭的常用基础方。Objective:To study the application characteristics and medication rules of oral Chinese medicine compound in acute heart failure by using data mining technology.Methods:The clinical randomized controlled trial studies of TCM compound in the treatment of acute heart failure from the establishment of the database to December 2023 were collected through five Chinese and foreign databases:CNKI,VIP,Wanfang,CBM and PubMed.Excel 2021 and R language(4.2.1)were used to analyze the frequency,association rules and clusters of the prescription to obtain the core drugs and new formulas.Results:A total of 189 prescriptions,including 207 traditional Chinese medicines,were included in this study,and a total of 1932 times use were included.Qi(气)deficiency and blood stasis,Yang(阳)deficiency and water flooding,and heart and kidney Yang deficiency were the most common syndrome types of acute heart failure.Traditional Chinese medicines such as Huangqi(Radix Astragali),Fuling(Poria),Danshen(Radix et Rhizoma Salviae Miltiorrhizae)and so on were used most frequently in clinical practice.The main flavor of these drugs was bitter,spicy and sweet.The highest frequency of meridian tropisms was the hand Taiyin(太阴)lung meridian,foot Taiyin spleen meridian and hand Shaoyin(少阴)heart meridian.Through correlation analysis,commonly used drug pairs such as Baizhu(Rhizoma Atractylodis Macrocephalae)-Fuling,Danshen-Huangqi and Fuling-Gancao(Radix Glycyrrhizae)were obtained respectively.After cluster analysis,four new prescription combinations were obtained.Conclusion:The basic pathogenesis of heart failure is deficiency in origin and excess in superficiality.Deficiency in origin is mainly manifested by Yang deficiency and Qi deficiency.The“excess in superficiality”is actually based on“blood stasis”and“water”.The treatment of acute heart failure is mainly to replenish Qi and warm Yang,supplemented by activating blood circulation to remove blood stasis and promoting Qi and diuresis.This study also excavated the commonly used bas

关 键 词：急性心力衰竭 数据挖掘 关联分析 聚类分析 用药规律 

分 类 号：R256.2[医药卫生—中医内科学]